Background: Evolving technologies in tissue adhesives offer interesting applications for the repair of the congenital cleft lip. The unique properties of Dermabond (octyl-2-cyanoacrylate) may facilitate optimal skin closure of cleft lip deformities thereby improving post-operative wound cosmesis. Methods: Eleven patients undergoing primary closure of congenital cleft lip anomalies, including the use of Dermabond tissue adhesive for skin closure, were recruited for study inclusion. A control group of 11 patients having undergone repair of congenital cleft lip with traditional suture skin closure were selected at random from the photographic archives of the Cleveland Clinic Department of Plastic and Reconstructive Surgery. A minimum interval of 9 months between lip repair and final post-operative photography was required in all patients. Cosmesis of cleft lip closure was assessed in a blinded fashion by 3 staff plastic surgeons using a visual analogue scale (VAS) and the Hollander Wound Evaluation Scale (HWES). Significance testing was performed by the Cleveland Clinic Department of Biostatistics and Epidemiology using the Wilcoxon Sign Rank Test. Results: The median photographic follow-up in patients treated with and without Dermabond was 13.4 and 20.9 months, respectively. The overall mean VAS score for the patients treated with and without Dermabond was 70.0 (SD 9.5) and 68.3 (SD 13.4), respectively (p=0.46). The overall mean HWES score for the patients treated with and without Dermabond was 1.7 (SD 1.7) and 1.7 (SD 1.7), respectively (p=0.92). Conclusions: The mature cosmetic appearance of the repaired congenital cleft lip anomaly using Dermabond tissue adhesive is comparable with the cosmetic appearance of the traditional technique of suture closure. The additional benefits of Dermabond, including speed and ease of application, the achievement of a watertight closure, and avoidance of suture removal make it a viable alternative for the skin closure in the repair of the congenital cleft lip anomaly.